CORE CURRICULUM FOR NEUROLOGY by mikesanye

VIEWS: 6 PAGES: 14

									                                   CORE CURRICULUM FOR UAMS NEUROLOGY RESIDENCY
PATIENT CARE
Neurology Patient Care (PGY2)
Objectives                                                       Teaching Methods                           Assessment Strategy

Obtain a comprehensive medical history, including essential      Supervised Direct Inpatient & Outpatient   Faculty rotation rating & evaluation
and accurate information about hospitalized patients with        Care                                       NEX live patient examinations
acute neurological symptoms, including neurological              Performance Feedback                       Program Director semi-yearly review
emergencies.                                                     Conferences
Obtain comprehensive medical history, including essential and    Supervised Direct Patient Care             Faculty rotation rating & evaluation
accurate information about hospitalized patients & outpatients   Performance Feedback                       NEX live patient examinations
with chronic neurological disorders and common neurological      Conferences                                Program Director semi-yearly review
symptoms.
Perform a comprehensive neurological examination and be          Clinical Teaching                          Faculty rotation rating & evaluation
able to summarize findings and localize the lesion in the        Clinical Experience                        RITE
central and/or peripheral nervous system, or determine another   Performance Feedback                       NEX live patient examinations
origin (e.g. systemic, psychiatric or psychogenic illness).      Conferences                                Program Director semi-yearly review
Formulate a differential diagnosis and management plan based     Clinical Teaching                          Faculty rotation rating & evaluation
upon your neurological assessment.                               Supervised Direct Patient Care             RITE
                                                                 Conferences                                NEX live patient examinations
Make informed decisions about diagnostic evaluations,            Clinical Teaching                          Faculty rotation rating & evaluation
including neuroimaging, neurophysiologic evaluation and          Performance Feedback                       NEX live patient examinations
laboratory investigation.                                        Weekly Neuroradiology Conference           Program Director semi-yearly review
                                                                 Weekly Clinical Neurophysiology
                                                                 Conference
Identify and describe abnormalities seen in common               Clinical Teaching                          Faculty evaluation of skills in
neurological disorders on neuroimaging testing.                  Performance Feedback                       Neuroradiology conference
                                                                 Weekly Neuroradiology Conference           Faculty observation & supervision
                                                                                                            RITE
Demonstrate technical skills in performing lumbar punctures.     Staff instruction /supervision             Faculty observation & supervision
Demonstrate technical and safe procedural skills in              Clinical teaching                          Faculty observation & supervision
performing such bedside testing as edrophonium test, caloric     Recommended reading
testing, and apnea test for brain death determination.
PATIENT CARE (cont)
Neurology Patient Care (PGY3 and 4)
Objectives                                                       Teaching Methods                              Assessment Strategy

Evaluate the application and relevance of investigative          Clinical teaching                             Faculty rotation rating & evaluation
procedures and interpretation in the diagnosis of neurological   Weekly Neuroradiology conference              RITE
disease, including the following:                                Weekly Clinical Neurophysiology conference    NEX live patient examinations
1. Electroencephalography                                        Review and instruction in EEG with staff      EMG end of course quiz
2. Motor and nerve conduction                                    Observation and instruction in EMG by staff   EEG end of course test
   studies                                                       Recommended reading
3. Electromyography
4. Evoked potentials
5. Polysomnography
6. Audiometry
7. Perimetry
8. Neuropsychological testing
9. Cerebrospinal fluid (CSF) analysis
10. Vascular imaging (Carotid Doppler/US, MRA, CTA)
11. Radiographic studies- X-ray, CT, MRI/MRA, nuclear
imaging studies, myelography
Identify and describe gross and microscopic specimens taken      Clinical teaching                             Faculty rotation rating & evaluation
from the normal nervous system and from patients with major      Recommended readings                          RITE
neurological disorders.                                          Neuropathology lectures

Based on a comprehensive neurological assessment, the            Clinical teaching                             Faculty rotation rating & evaluation
physician shall demonstrate the ability to recognize and treat   Recommended reading                           RITE
neurological disorders commonly encountered in the hospital      Departmental Conferences                      NEX live patient examinations
setting                                                          Didactics                                     Program Director semi-yearly review
Based on a comprehensive neurological assessment, the            Clinical teaching                             Faculty rotation rating & evaluation
physician shall demonstrate the ability to recognize and treat   Recommended reading                           RITE
neurological disorders commonly encountered in the               Departmental Conferences                      NEX live patient examinations
outpatient setting                                               Didactics                                     Program Director semi-yearly review
  MEDICAL KNOWLEDGE
Neurology (PGY2) Medical Knowledge
Objectives                                                                 Teaching Methods                      Assessment Strategy
The physician shall demonstrate knowledge of the pathophysiology           Clinical teaching                     Faculty rotation rating & evaluation
of major neurological disorders and familiarity with the scientific        Review of evidence based guidelines   RITE
basis of neurological diseases.                                            and practice parameters proposed by   NEX live patient examinations
                                                                           the AAN                               Program Director semi-yearly review
                                                                           Departmental Conferences
                                                                           Reading list
The physician shall demonstrate knowledge of patient evaluation and        Clinical teaching                     Faculty rotation rating & evaluation
treatment selection, including:                                            Didactic lectures, including basic    RITE
     The nature of patients’ history and physical findings and the        science lecture series                NEX live patient examinations
        ability to correlate the findings with a likely localization for   Grand Rounds                          Program Director semi-yearly review
        neurological dysfunction.                                          Journal clubs
     Likely diagnoses and differential diagnoses.                         Review of evidence based guidelines
     Planning for evaluation and management.                              and practice parameters proposed by
     Potential risks and benefits of potential therapies, including       the AAN
        surgical procedures.                                               Reading list
Compare and contrast the medical and surgical approaches to                Clinical teaching                     Faculty rotation rating & evaluation
treatment of neurological disorders and explain the conditions under       Didactic lectures, including basic    RITE
which each would be most efficacious.                                      science lecture series                NEX live patient examinations
                                                                           Grand Rounds                          Program Director semi-yearly review
                                                                           Journal clubs
                                                                           Review of evidence based guidelines
                                                                           and practice parameters proposed by
                                                                           the AAN
                                                                           Reading list
Demonstrate the approach to assessing an acute change in mental            Clinical teaching                     Faculty rotation rating & evaluation
status/coma and distinguish between different etiologies such as           Didactic lectures                     RITE
metabolic, toxic, infections, or vascular.                                 Journal clubs                         NEX live patient examinations
                                                                           Review of evidence based guidelines   Program Director semi-yearly review
                                                                           and practice parameters of the AAN
MEDICAL KNOWLEDGE (cont)
Neurology (PGY2) Medical Knowledge (Cont.)
Objectives                                                              Teaching Methods                        Assessment Strategy
Demonstrate an analytical thinking approach to a patient presenting     Clinical teaching                       Faculty rotation rating & evaluation
with acute weakness in order to distinguish whether the lesion can be   Didactic lectures                       RITE
attributable to the central nervous system (brain or spinal cord) or                                            NEX live patient examinations
peripheral nervous system (nerve root, peripheral nerve,                                                        Program Director semi-yearly review
neuromuscular junction or muscle) based upon assessment of upper
or lower motor neuron signs.
Demonstrate knowledge of relevant neuroanatomy and underlying           Clinical teaching                       Faculty rotation rating & evaluation
pathology found in neoplasms, multiple sclerosis, Alzheimer’s           Didactic conferences, including basic   RITE
dementia, Parkinson’s disease and cerebrovascular disease               science conferenc                       Program Director semi-yearly review
                                                                        Weekly Neuropathology conference

The physician shall demonstrate the ability to reference and utilize    Clinical teaching                       Faculty rotation rating & evaluation
electronic systems to access medical, scientific, and patient           Library services
information.                                                            EMR training
The physician shall demonstrate a knowledge of psychiatry,              Psychiatry rotation in either PGY1      Faculty rotation rating & evaluation
including:                                                              (or PGY2,3,4 years) on the consult      RITE
     Psychopathology, epidemiology, diagnostic criteria, and           liaison service                         NEX live patient examinations
        clinical course for common psychiatric disorders.               Psychiatry didactic lectures
     Drug dependence and substance abuse.
     Interplay between psychogenic and neurologic clinical
        manifestations, including somatization and conversion
        disorders
     Management of uncomplicated psychiatric disorders and
        indications for consultation
     Psychopharmacology including major drug categories and
        potential side effects
     Nonpharmocologic treatment approaches
MEDICAL KNOWLEDGE (cont)
Neurology (PGY3 and 4) Medical Knowledge
Objectives                                                          Teaching Methods                      Assessment Strategy
The physician shall demonstrate progressive knowledge of patient    Cinical teaching                      Faculty rotation rating & evaluation
evaluation and treatment selection, including:                      Didactic lectures, including basic    RITE
     The nature of patients’ history and physical findings and     science lecture series                NEX live patient examinations
         the ability to correlate the findings with a likely        Grand Rounds                          Program Director semi-yearly review
         localization for neurological dysfunction.                 Journal clubs
     Likely diagnoses and differential diagnoses in adults and     Reading list
         children
     Planning for evaluation and management.
     Potential risks and benefits of potential therapies,
         including surgical procedures.
The physician shall demonstrate knowledge of the major              Cinical teaching                      Faculty rotation rating & evaluation
disorders, including considerations relating to age, gender, race   Didactic lectures, including basic    RITE
and ethnicity, based on the literature and standards of practice.   science lecture series                NEX live patient examinations
This knowledge shall include:                                       Grand Rounds                          Program Director semi-yearly review
 The epidemiology of the disorder.                                 Journal clubs
 The etiology of the disorder, including medical, genetic, and     Reading list
    sociocultural factors.                                          Review of evidence based guidelines
 The phenomenology of the disorder.                                and practice parameters of the AAN
 The experience, meaning, and explanation of the illness for
    the patient and family, including the influence of cultural
    factors and culture-bound syndromes.
 Effective treatment strategies, course, and prognosis.
Critically evaluate and judiciously apply the latest knowledge of   Cinical teaching                      Faculty rotation rating & evaluation
basic neuroscience that is critical to the practice of neurology    Didactic lectures, including basic    RITE
                                                                    science lecture series                NEX live patient examinations
                                                                    Grand Rounds                          Program Director semi-yearly review
                                                                    Journal clubs
                                                                    Reading list
                                                                    Review of evidence based guidelines
                                                                    and practice parameters of the AAN
Neurology (PGY3 and 4) Medical Knowledge (cont.)
Objectives                                                        Teaching Methods                      Assessment Strategy
Characterize the main features of neurological disorders and      Cinical teaching                      Faculty rotation rating & evaluation
diseases that span across a lifespan, and compare and contrast    Didactic lectures, including basic    RITE
available treatment options for the following:                    science lecture series                NEX live patient examinations
     Dementia and behavioral neurology disorders                 Grand Rounds                          Program Director semi-yearly review
     Epilepsy and related disorders                              Journal clubs
     Neuromuscular disorders                                     Reading list
     Demyelinating disorders of the central & peripheral         Review of evidence based guidelines
        nervous system                                            and practice parameters of the AAN
     Cerebrovascular disorders
     Infectious diseases of the nervous system
     Neoplastic disorders of the nervous system
     Nervous system trauma
     Toxic and metabolic disorders of the nervous system
     Acute & chronic pain
     Sleep disorders
     Changes in mental status secondary to therapy
     Critical care and emergency neurology
     Coma and brain death
     Headache and facial pain
     Movement disorders
The physician shall demonstrate knowledge of the                  Cinical teaching                      Faculty rotation rating & evaluation
pathophysiology of major neurological disorders and familiarity   Didactic lectures, including basic    RITE
with the scientific basis of neurological diseases.               science lecture series                Program Director semi-yearly review
                                                                  Weekly Neuropathology conference
                                                                  Grand Rounds
                                                                  Journal clubs
                                                                  Reading list




Demonstrate the employment of principles of quality               Cinical teaching                      Faculty rotation rating & evaluation
improvement in practice                                           Weekly Neuropathology conference      Program Director semi-yearly review
                                                                  Monthly QA (M&M) conference
INTERPERSONAL AND COMMUNICATION SKILLS
Neurology (PGY 2) Interpersonal and Communication Skills
Objectives                                                              Teaching Methods             Assessment Strategy
Demonstrate the ability to obtain, interpret and evaluate               Clinical rounds & teaching   Faculty rotation rating & evaluation
consultations from other medical specialties and to communicate a       Outpatient clinic teaching
diagnostic and management plan.
Provide patients and their families explanations of neurological        Clinical rounds & teaching   Faculty rotation rating & evaluation
disorders and treatment that is geared to their educational level, as   Outpatient clinic teaching   NEX live patient examinations
well as respecting the patient’s cultural, ethnic, religious and                                     Evaluation by nursing staff
economic backgrounds.
Convey information to patients in a clear and meaningful fashion        Clinical rounds & teaching   Faculty rotation rating & evaluation
and partner with patients to develop an agreed upon healthcare          Outpatient clinic teaching   NEX live patient examinations
management plan.                                                                                     Evaluation by nursing staff

Work collaboratively with the multidisciplinary team involved in        Clinical rounds & teaching   Faculty rotation rating & evaluation
the inpatient care of neurological patients.                            Outpatient clinic teaching   NEX live patient examinations
                                                                                                     Evaluation by nursing staff

Develop and maintain a therapeutic alliance with patients by            Clinical rounds & teaching   Faculty rotation rating & evaluation
instilling feelings of trust, honesty, openness, rapport, and comfort   Outpatient clinic teaching   NEX live patient examinations
in the relationship with the physician.                                 Online HIPAA training        Evaluation by nursing staff
INTERPERSONAL AND COMMUNICATION SKILLS (cont)
Neurology (PGY 3 and 4) Interpersonal and Communication
Skills
Objectives                                                            Teaching Methods             Assessment Strategy
Provide leadership, direction and instruction to junior members of    Clinical Rounds & teaching   Faculty rotation rating & evaluation
the team in a way that fosters their skills as a physician.           Outpatient clinic teaching   NEX live patient examinations
                                                                                                   Evaluation by nursing staff
Demonstrate effective communication within the team, with             Clinical Rounds & teaching   Faculty rotation rating & evaluation
regards to patients’ current or change in neurologic status,          Outpatient clinic teaching   NEX live patient examinations
anticipated problem, therapeutic regimen and diagnostic tests to be                                Evaluation by nursing staff
reviewed.
To listen to and understand patients and to attend to nonverbal       Clinical Rounds & teaching   Faculty rotation rating & evaluation
communication.                                                        Outpatient clinic teaching   NEX live patient examinations
                                                                                                   Evaluation by nursing staff
To educate patients and professionals about medical,                  Clinical Rounds & teaching   Faculty rotation rating & evaluation
psychosocial, and behavioral issues.                                  Outpatient clinic teaching   NEX live patient examinations
                                                                                                   Evaluation by nursing staff
To partner with patients to develop an agreed upon healthcare         Clinical Rounds & teaching   Faculty rotation rating & evaluation
management plan.                                                      Outpatient clinic teaching   NEX live patient examinations
                                                                                                   Evaluation by nursing staff
Recognize one’s own feelings and behaviors in dealing with            Clinical Rounds & teaching   Faculty rotation rating & evaluation
difficult situations so that they do not interfere with appropriate   Outpatient clinic teaching   NEX live patient examinations
treatment                                                             Ethics conferences           Evaluation by nursing staff
PRACTICE BASED LEARNING AND IMPROVEMENT
Neurology (PGY 1) Practice Based Learning and Improvement
Objectives                                                                Teaching Methods                          Assessment Strategy
Physicians shall recognize limitations in their own knowledge             Direct patient care & clinical teaching   Faculty rotation rating & evaluation
base & clinical skills, and understand & address the need for             Q/A (M&M) conference                      Evaluation by nursing staff
lifelong learning.                                                        Journal Clubs                             Program Director semi-yearly review

The physician shall demonstrate appropriate skills for obtaining          Internet medical information system,      Faculty rotation rating & evaluation
and evaluating up to date information from scientific and practice        medical searches, national conference     Evaluation by nursing staff
literature and other sources to assist in the quality care of patients.   attendance.                               Program Director semi-yearly review
This should include educational courses, conferences
The physician shall evaluate caseload and practice experience in a        Direct patient care & clinical teaching   Faculty rotation rating & evaluation
systematic manner                                                         Review of evidence based guidelines       Evaluation by nursing staff
                                                                          and practice parameters proposed by       Personal portfolio (encouraged)
                                                                          the AAN
                                                                          Q/A (M&M) conference
The physician shall demonstrate responsibility for his/her patients’      Direct patient care & clinical teaching   Faculty rotation rating & evaluation
care, including:                                                          Journal clubs                             Evaluation by nursing staff
    1. Responding to communication from patients and health               Review of evidence based guidelines       Personal portfolio (encouraged)
         professionals in a timely manner.                                and practice parameters proposed by
    2. Establishing and communicating back-up arrangements,               the AAN
         including how to seek emergent and urgent care when              Patient centered literature review
         necessary.                                                       Daily hand-off to on-call resident
    3. Using medical records for appropriate documentation of
         the course of illness and its treatment.
    4. Providing coverage if unavailable, e.g., out of town, on
         vacation.
    5. Providing for continuity of care, including appropriate
         consultation, transfer, or referral if necessary.
PRACTICE BASED LEARNING AND IMPROVEMENT (cont)
Neurology (PGY 3 and 4) Practice Based Learning and
Improvement
Objectives                                                      Teaching Methods                       Assessment Strategy
Evaluate the clinical literature applying knowledge of          Teaching conferences including Grand   Faculty rotation rating & evaluation
epidemiology, biostatistics, and research study design          Rounds                                 Presentations at meetings
                                                                Journal Clubs                          Publications
                                                                Involvement in research
Facilitate the learning of medical students                     Oral presentations                     Faculty rotation rating & evaluation
                                                                Patient Centered instruction           Personal portfolio (encouraged)
Demonstrate the ability to:                                     Grand Rounds                           Faculty rotation rating & evaluation
  1. Review and critically assess scientific literature to      Clinical teaching                      Evaluation by nursing staff
     determine how quality of care can be improved in           Journal clubs                          Personal portfolio (encouraged)
     relation to one’s practice (e.g., reliable and valid       Review of evidence based guidelines    Program Director semi-yearly review
     assessment techniques, treatment approaches with           and practice parameters of the AAN
                                                                Patient centered literature review
     established effectiveness, practice parameter
     adherence). Within this aim, the physician shall be
     able to assess the generalizability or applicability of
     research findings to one’s patients in relation to their
     sociodemographic and clinical characteristics.
  2. Develop and pursue effective remediation strategies
     that are based on critical review of scientific
     literature.
  3. Learn from one’s own and other specialties.
PROFESSIONALISM
Neurology (PGY 2) Professionalism
Objectives                                                           Teaching Methods                          Assessment Strategy
Interact responsibly with patients, families and co-workers taking   Direct patient care & clinical teaching   Faculty rating & evaluation
into consideration age, disability, culture and gender issues.       Ethics case reviews                       Evaluation by nursing staff
                                                                     Online ethics training
Demonstrate appropriate use of the EMR in regards to patient         Direct patient care & clinical teaching   Faculty rating & evaluation
respect and confidentiality.                                         Ethics case reviews                       Evaluation by nursing staff
                                                                     Online ethics training
                                                                     EMR training
                                                                     Online HIPAA training
The physician shall review his/her professional conduct and          Direct patient care & clinical teaching   Faculty rating & evaluation
remediate when appropriate.                                          Ethics case reviews                       Evaluation by nursing staff
                                                                     Online ethics training                    Program Director semi-yearly review
                                                                     QA (M&M) conference
The physician shall demonstrate ethical behavior, integrity,         Direct patient care & clinical teaching   Faculty rating & evaluation
honesty, compassion, and confidentiality in the delivery of care,    Ethics case reviews                       Evaluation by nursing staff
including matters of informed consent/assent, professional           Online ethics training
conduct, and conflict of interest.
The physician shall demonstrate understanding of and sensitivity     Direct patient care & clinical teaching   Faculty rating & evaluation
to end of life care and issues regarding provision of care.          Ethics conference                         Evaluation by nursing staff
                                                                     Online ethics training
The physician shall participate in the review of the professional    Direct patient care & clinical teaching   Faculty rating & evaluation
conduct of his/her colleagues.                                       Ethics case reviews
                                                                     QA (M&M) conference

The physician shall acknowledge and remediate medical errors,        Direct patient care & clinical teaching   Faculty rating & evaluation
should they occur.                                                   Ethics case reviews                       Evaluation by nursing staff
                                                                     QA (M&M) conference                       Program Director semi-yearly review
Neurology (PGY 3 and 4) Professionalism
Objectives                                                           Teaching Methods                          Assessment Strategy
Describe the differences of withdrawal of care, termination of       Direct patient care & clinical teaching   Faculty rating & evaluation
care, and non-initiation of care and assist patients and their       Ethics conference                         Evaluation by nursing staff
families in choosing these options in the appropriate clinical
setting.
The physician shall participate in the review of the professional   Teaching rounds       Faculty rating & evaluation
conduct of his/her colleagues.                                      Back-up call          Evaluation by nursing staff
                                                                    QA (M&M) conference
The physician shall acknowledge and remediate medical errors,       Teaching rounds       Faculty rating & evaluation
should they occur.                                                  Back-up call          Evaluation by nursing staff
                                                                    QA (M&M) conference   Program Director semi-yearly review
SYSTEM BASED PRACTICE
Neurology (PGY 2) System Based Practice
Objectives                                                           Teaching Methods                     Assessment Strategy
The physician shall have a working knowledge of the diverse          Direct supervised patient care       Faculty rating & evaluation
systems involved in treating patients of all ages and understand     Interaction with social service      Evaluation by nursing staff
how to use the systems as part of a comprehensive system of care     Review of evidence based medicine
in general, and as part of a comprehensive, individualized           and guidelines of the AAN
treatment plan. The physician shall be able to:                      Departmental conferences including
    1. Use practice guidelines.                                      QA (M&M)
    2. Access community, national, and allied health
        professional resources, which may enhance the quality of
        life of patients with chronic psychiatric and neurological
        illnesses.
    3. Demonstrate the ability to lead and delegate authority to
        healthcare teams needed to provide comprehensive care
        for patients with psychiatric and neurological disease.
    4. Demonstrate skills for the practice of ambulatory
        medicine, including time management, clinic scheduling,
        and efficient communication with referring physicians.
    5. Utilize appropriate consultation and referral mechanisms
        for the optimal clinical management of patients with
        complicated medical illnesses.
Demonstrate awareness of the importance of adequate cross            Direct supervised patient care       Faculty rating & evaluation
coverage. Use accurate medical data in the communication with        Hand-off to on-call resident         Evaluation by nursing staff
and effective management of patients.                                                                     Program Director semi-yearly review
The physician shall demonstrate knowledge of and interact with       Direct supervised patient care       Faculty rating & evaluation
managed health care systems and Medicare.                            Interaction with social service      Evaluation by nursing staff
                                                                     Review of evidence based medicine    Program Director semi-yearly review
                                                                     and guidelines of the AAN
                                                                     Departmental conferences including
                                                                     QA (M&M)
SYSTEM BASED PRACTICE (cont)
 Neurology (PGY3 and 4) System Based Practice
Objectives                                                             Teaching Methods                    Assessment Strategy
In the community system, the physician shall:                          Direct supervised patient care      Faculty rating & evaluation
     1. Recognize the limitation of healthcare resources and           Interaction with social service     Evaluation by nursing staff
         demonstrate the ability to act as an advocate for patients    Review of evidence based medicine
         within their sociocultural and financial constraints.         and guidelines of the AAN
     2. Demonstrate knowledge of the legal aspects of psychiatric
         and neurological diseases as they impact patients and their
         families.
     3. Demonstrate an understanding of risk management.
The physician shall demonstrate knowledge of and interact with         Direct supervised patient care      Faculty rating & evaluation
managed health care systems and Medicare.                              Interaction with social service     Evaluation by nursing staff
                                                                       Review of evidence based medicine   Program Director semi-yearly review
                                                                       and guidelines of the AAN
The physician shall demonstrate knowledge of community                 Direct supervised patient care      Faculty rating & evaluation
systems of care and assist patients to access appropriate care and     Interaction with social service     Evaluation by nursing staff
other support services.                                                Review of evidence based medicine   Program Director semi-yearly review
                                                                       and guidelines of the AAN

								
To top